Inhaled lidocaine for prevention of hemodynamic changes in laryngoscopy and intubation

This study was undertaken to examine the efficacy of lidocaine aerosol pretreatment in attenuating hemodynamic (HD) responses secondary to laryngoscopy and tracheal intubation in patients undergoing surgery for intracranial space occupying lesions (ICSOL). A semiclosed breathing system was improvised to generate aerosol of consistent density. Five percent lidocaine was nebulized in two different dosages (0.2 and 0.1 ml/kg in groups A and B, respectively); group C (control) received aerosol of normal saline. The average aerosol-treatment time was 24, 12, and 16 min in groups A, B, and C, respectively. Changes in heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and rate pressure product (RPP) were analyzed by analysis of variance (ANOVA). In group A, tracheal intubation did not cause significant HD changes. In group B, a significant increase was observed in each HD parameter which, when compared with control, was less severe. Lidocaine toxicity, regurgitation, nausea, vomiting, or aspiration did not occur in any patient. Patients accepted the procedure well. This study found efficacy of the technique to be related to duration of aerosol treatment.